Restricting Elective Inductions Reduces Cesareans

May 6, 2013

New Orleans, LA -- Policies restricting elective labor induction reduce time from admission to delivery, as well as reduce cesarean delivery rates, according to new research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists. Researchers say the policies benefit both mothers and babies.

Andrew J. Healy, MD, along with colleagues at Baystate Medical Center in Springfield, MA, studied the records of all singleton births at the hospital before and after a policy was implemented that restricted elective labor inductions. The researchers looked at the time from admission to delivery, cesarean rates, NICU admission rates, and stillbirths among 9,515 singleton births before Baystate implemented the policy, as well as 2,641 singleton births after the policy. The new policy allowed elective inductions for pregnant women who had a history of a prior successful vaginal delivery, had a favorable cervix, and were at least 39 weeks and zero days gestation.

The average time from hospital admission to delivery for elective inductions decreased immediately post-policy implementation by six hours compared with pre-implementation, dropping from 17 hours to 11 hours. Average time-to-delivery for elective inductions decreased after policy implementation by an average of 30 minutes per month. The cesarean delivery rate for the elective induction patients decreased from 16% to 7% in the pre- and post-policy implementation. NICU admission rate decreased from 3% to 2%, representing a 33% reduction in the admission of term babies to the NICU.

“What we used to see here were some providers performing elective inductions in patients, many of whom were fewer than 39 weeks of gestation, with unfavorable cervices. These inductions could take two days, and sometimes three days, and many would end in a cesarean delivery,” said Dr. Healy. “We don’t see that anymore since implementing a policy restricting elective labor induction, which is terrific. The chance of a newborn going to the NICU is much less. The mothers are more likely to be able to take their baby home with them, and having had a vaginal birth, are less uncomfortable and better able to care for their child.”

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org